Search Results (1,252)

Background: Large language models (LLMs) such as ChatGPT have evolved rapidly, with notable improvements in coherence, factual accuracy, and contextual relevance. However, their academic and clinical applicability remains under scrutiny. This study evaluates the temporal performance evolution of LLMs by comparing earlier model outputs (GPT-3.5 and GPT-4.0) with ChatGPT-4.5 across three domains: aesthetic surgery counseling, an academic discussion base of thumb arthritis, and a systematic literature review. Methods: We replicated the methodologies of three previously published studies using identical prompts in ChatGPT-4.5. Each output was assessed against its predecessor using a nine-domain Likert-based rubric measuring factual accuracy, completeness, reference quality, clarity, clinical insight, scientific reasoning, bias avoidance, utility, and interactivity. Expert reviewers in plastic and reconstructive surgery independently scored and compared model outputs across versions. Results: ChatGPT-4.5 outperformed earlier versions across all domains. Reference quality improved most significantly (a score increase of +4.5), followed by factual accuracy (+2.5), scientific reasoning (+2.5), and utility (+2.5). In aesthetic surgery counseling, GPT-3.5 produced generic responses lacking clinical detail, whereas ChatGPT-4.5 offered tailored, structured, and psychologically sensitive advice. In academic writing, ChatGPT-4.5 eliminated reference hallucination, correctly applied evidence hierarchies, and demonstrated advanced reasoning. In the literature review, recall remained suboptimal, but precision, citation accuracy, and contextual depth improved substantially. Conclusion: ChatGPT-4.5 represents a major step forward in LLM capability, particularly in generating trustworthy academic and clinical content. While not yet suitable as a standalone decision-making tool, its outputs now support research planning and early-stage manuscript preparation. Persistent limitations include information recall and interpretive flexibility. Continued validation is essential to ensure ethical, effective use in scientific workflows. Full article

This article explores the ways in which writing about natural disasters conveyed a fraught sense of instability and ever-changing political alliances in the early sixteenth century. It centers on a broadsheet comprising two letters and a song sent to a Castilian statesman, the Marquis of Tarifa, from the papal curia and the court of Portugal. The two letters, one by Baltasar del Río and another by an anonymous informant, reveal that disasters could be potentially seen as moments of political action. By the beginning of the sixteenth century, the papal curia suffered several floods, the plague, factional violence, and internal divisions with long-lasting consequences. In turn, Lisbon, was hit by a major earthquake, which impacted major structures. These letters allow us to reconstruct how the concept of curiosity and that of an untamable nature came together to make sense of natural disasters, such as floods and earthquakes. I analyze the ways in which Iberian agents negotiated the supposedly natural or divine character of these events in order to advance political and religious calls for action. Full article

Proxy data-based reconstructions provide an essential basis for understanding comprehensive precipitation variability at multiple time scales. This study compared the variation characteristics of reconstructed precipitation data across different regions in the U.S. and the differences at decadal/multidecadal scales. The reconstruction showed that multiple scales of precipitation variability existed in each region and both multidecadal and decadal variability varied over time and across region. There was weaker multidecadal variability in the latter half of the 18th century and during the mid-19th century to mid-20th century east of the Rocky Mountains (RM); however, multidecadal variability appears to have increased since the 20th century in most regions. Decadal variability was weaker west of the RM except in the Southwest U.S. in the latter half of the 18th century. While decadal variability became stronger in the early 20th century, it shifted from a stronger phase to a weaker phase east of the RM. Then, we compared the spatiotemporal differences between the reconstructed Palmer Drought Severity Index (PDSI) and reconstructed precipitation in this study. The reconstructed annual precipitation mostly remains consistent with the existing PDSI dataset, but there are inconsistencies in the severe dry/wet intensities in some regions. Multiscale analysis of regional precipitation data holds great importance for understanding the relationship between precipitation in different regions and the climate system, while also providing a scientific theoretical basis for precipitation prediction. Full article

Accurate identification of the endometrial region is critical for the early detection of endometrial lesions. However, current detection models still face two major challenges when processing endometrial imaging data: (1) In complex and noisy environments, recognition accuracy remains limited, partly due to the insufficient exploitation of color information within the images; (2) Traditional Two-dimensional PCA-based (2DPCA-based) feature selection methods have limited capacity to capture and represent key characteristics of the endometrial region. To address these challenges, this paper proposes a novel algorithm named Feature-Level Image Fusion and Improved Swarm Intelligence Optimization Algorithm (FLFSI), which integrates a learning guided binary particle swarm optimization (BPSO) strategy with an image feature selection and reconstruction framework to enhance the detection of endometrial regions in clinical ultrasound images. Specifically, FLFSI contributes to improving feature selection accuracy and image reconstruction quality, thereby enhancing the overall performance of region recognition tasks. First, we enhance endometrial image representation by incorporating feature engineering techniques that combine structural and color information, thereby improving reconstruction quality and emphasizing critical regional features. Second, the BPSO algorithm is introduced into the feature selection stage, improving the accuracy of feature selection and its global search ability while effectively reducing the impact of redundant features. Furthermore, we refined the BPSO design to accelerate convergence and enhance optimization efficiency during the selection process. The proposed FLFSI algorithm can be integrated into mainstream detection models such as YOLO11 and YOLOv12. When applied to YOLO11, FLFSI achieves 96.6% Box mAP and 87.8% Mask mAP. With YOLOv12, it further improves the Mask mAP to 88.8%, demonstrating excellent cross-model adaptability and robust detection performance. Extensive experimental results validate the effectiveness and broad applicability of FLFSI in enhancing endometrial region detection for clinical ultrasound image analysis. Full article

Domain adaptation of pre-trained language models remains challenging, especially for specialized text collections that include distinct vocabularies and unique semantic structures. Existing contrastive learning methods frequently rely on generic masking techniques and coarse-grained similarity measures, which limit their ability to capture fine-grained, domain-specific linguistic nuances. This paper proposes an enhanced domain adaptation framework by integrating weighted contrastive learning guided by large language model (LLM) feedback and a novel topic-aware masking strategy. Specifically, topic modeling is utilized to systematically identify semantically crucial domain-specific terms, enabling the creation of meaningful contrastive pairs through three targeted masking strategies: single-keyword, multiple-keyword, and partial-keyword masking. Each masked sentence undergoes LLM-guided reconstruction, accompanied by graduated similarity assessments that serve as continuous, fine-grained supervision signals. Experiments conducted on an early 20th-century science fiction corpus demonstrate that the proposed approach consistently outperforms existing baselines, such as SimCSE and DiffCSE, across multiple linguistic probing tasks within the newly introduced SF-ProbeEval benchmark. Furthermore, the proposed method achieves these performance improvements with significantly reduced computational requirements, highlighting its practical applicability for efficient and interpretable adaptation of language models to specialized domains. Full article

Background/Objectives: Tapered, fluted, modular titanium stems (TFTSs) are widely used in complex femoral reconstructions during total hip arthroplasty (THA), but evidence regarding the clinical performance of specific modular implant designs remains limited. This study aimed to compare the early clinical and radiographic outcomes of complex primary and revision THA using the M-Vizion^® modular stem system. Methods: We retrospectively analyzed 109 patients (46 complex primary and 63 revision THA cases) treated with the M-Vizion^® cementless modular TFTSs between 2020 and 2023. Clinical outcomes were assessed using the Hip Disability and Osteoarthritis Outcome Score (HOOS) and the Forgotten Joint Score (FJS) at 1- and 2-years post-surgery. Radiographic evaluation included stem subsidence, radiolucent lines, heterotopic ossification, and complications. Clinically relevant subsidence was defined as >5 mm. Statistical analysis was performed using ANOVA. Results: The mean follow-up was 33.3 months for complex primary and 31.8 months for revision THA. Both groups demonstrated significant improvement in FJS over time (p < 0.05). In the revision group, HOOS improved significantly from baseline to follow-up (p < 0.001). Mean stem subsidence was 2.1 mm in the complex primary group and 1.8 mm in the revision group; nine patients (8.3%) had subsidence greater than 5 mm. No cases of aseptic loosening or stem fracture were observed. The overall complication rate was low, with dislocations (3.2%) and infections (2.8%) requiring revision. Conclusions: The M-Vizion^® TFTS system demonstrated favorable short-term outcomes in both complex primary and revision THA. These findings suggest potential utility in complex femoral reconstruction, although confirmation through longer-term studies is warranted. Full article

Anomaly detection is inherently challenging, as anomalies typically emerge only at test time. While reconstruction-based methods are popular, their reliance on CNN backbones with local receptive fields limits discrimination and precise localization. We propose FFC-AD, a reconstruction framework using Fourier Feature Convolutions (FFCs) to capture global information early, and we introduce Hidden Space Anomaly Simulation (HSAS), a latent-space regularization strategy that mitigates overgeneralization. Experiments on MVTec AD and VisA demonstrate that FFC-AD significantly outperforms state-of-the-art methods in both detection and segmentation accuracy. Full article

Continuous cardiovascular monitoring is essential for the early detection of cardiac events, but conventional electrode-based ECG systems cause skin irritation and are unsuitable for long-term wear. We propose an electrode-free ECG monitoring approach that leverages synchronized phonocardiogram (PCG) and seismocardiogram (SCG) signals captured by wireless mechano-acoustic sensors. PCG provides precise valvular event timings, while SCG provides mechanical context, enabling the robust identification of systolic/diastolic intervals and pathological patterns. A deep learning model reconstructs ECG waveforms by intelligently combining mechano-acoustic sensor data. Its architecture leverages specialized neural network components to identify and correlate key cardiac signatures from multimodal inputs. Experimental validation on an IoT sensor dataset yields a mean Pearson correlation of 0.96 and an RMSE of 0.49 mV compared to clinical ECGs. By eliminating skin-contact electrodes through PCG–SCG fusion, this system enables robust IoT-compatible daily-life cardiac monitoring. Full article

The hippocampus is a key structure involved in the early pathological progression of Alzheimer’s disease. Accurate segmentation of this region is vital for the quantitative assessment of brain atrophy and the support of diagnostic decision-making. To address limitations in current MRI-based hippocampus segmentation methods—such as indistinct boundaries, small target size, and limited feature representation—this study proposes an enhanced segmentation framework called FED-UNet++. The residual feature reconstruction block (FRBlock) is introduced to strengthen the network’s ability to capture boundary cues and fine-grained structural details in shallow layers. The efficient attention pyramid (EAP) module enhances the integration of multi-scale features and spatial contextual information. The dynamic frequency context network (DFCN) mitigates the decoder’s limitations in capturing long-range dependencies and global semantic structures. Experimental results on the benchmark dataset demonstrate that FED-UNet++ achieves superior performance across multiple evaluation metrics, with an IoU of 74.95% and a Dice coefficient of 84.43% ± 0.21%, outperforming the baseline model in both accuracy and robustness. These findings confirm that FED-UNet++ is highly effective in segmenting small and intricate brain structures like the hippocampus, providing a robust and practical tool for MRI-based analysis of neurodegenerative diseases. Full article

Background: Gastric cancer is increasingly being diagnosed at early stages, enabling the application of curative oncological and surgical approaches. With the growing adoption of minimally invasive techniques, robotic surgery is gaining increasing prominence in the operating rooms. As described by Stoyanova et al., the robotic completely intracorporeal jejunal pouch reconstruction after gastrectomy offers potential benefits, including technical feasibility without significant intraoperative challenges or prolonged operative times, as well as long-term advantages such as a reduced incidence of midline incision hernias. Objectives: This retrospective, single-center study is the first to compare the clinical and oncological outcomes after laparoscopic versus robotic completely intracorporeal jejunal pouch reconstruction following gastrectomy. Methods: A total of 27 patients who underwent gastrectomy between 2018 and 2025 were included in the study, and were divided into two groups: 12 patients in the robotic and 15 patients in the laparoscopic group. The study evaluated mean operative time, intraoperative and postoperative complications, length of hospital and ICU stay, and certain oncological outcomes. Results: A main purpose of the robotic method is the avoidance of an unfavourable midline incision due to the completely intracorporeal pouch reconstruction without substantial technical or clinical disadvantages. Conclusions: Further research involving larger patient cohorts and extended follow-up periods is necessary to draw more definitive conclusions about the relative advantages of this surgical technique. Full article

The Nam Phong Formation, a key unit of the pre-Khorat Group in the western Khorat Plateau, provides critical insights into the Mesozoic geological evolution of northeastern Thailand. This study presents the first integrated petrographic and geochemical investigation of the formation within Khon Kaen Geopark to reconstruct its Late Triassic–Early Jurassic depositional settings, provenance, and paleoclimate. A detailed stratigraphic section and five supplementary sites reveal litharenite and lithic wacke sandstones, interbedded with red paleosols and polymictic conglomerates. Sedimentary structures—such as trough and planar cross-bedding, erosional surfaces, and mature paleosols—indicate deposition in a high-energy braided fluvial system under semi-arid to subhumid conditions with episodic subaerial exposure. Petrographic analysis identifies abundant quartz, feldspar, and volcanic lithic fragments. Geochemical data and REE patterns, including diagnostic negative Ce anomalies, provide compelling evidence for provenance from active continental margins and oxidizing weathering conditions. These findings point to a tectonically active syn-rift basin influenced by climatic variability. Strikingly, the Nam Phong Formation exhibits paleoenvironmental and sedimentological features comparable to the modern Ebro Basin in northeastern Spain, highlighting the relevance of uniformitarian principles in interpreting ancient continental depositional systems. Full article

Lubricating oil degradation directly impacts friction coefficient, wear rate, and lubrication regime transitions, making precise health quantification essential for predictive tribological maintenance. However, conventional evaluation methods fail to capture subtle tribological changes preceding lubrication failure, often oversimplifying complex multi-parameter relationships critical to friction and wear performance. To address this challenge, this study proposes Seasonal–Trend decomposition using Loess, a Factor Attention Network, a Temporal Convolutional Network, and an Informer with Long Short-Term Memory Variational Autoencoder (SFTI-LVAE) framework for continuous tribological health assessment of diesel engine lubricants. The approach integrates Seasonal–Trend decomposition using Loess (STL) for trend–seasonal separation, a Factor Attention Network (FAN) for multidimensional feature fusion, and a Temporal Convolutional Network (TCN)-enhanced Informer for capturing long-term tribological dependencies. By combining Long Short-Term Memory (LSTM) temporal modeling with Variational Autoencoder (VAE) reconstruction, the method quantifies lubricant health through reconstruction error, establishing a direct correlation between data deviation and tribological performance degradation. Additionally, permutation importance-based feature evaluation and parameter contribution quantification techniques enable deep mechanistic analysis and fault source tracing of lubricant health degradation. Experimental validation using multi-sensor monitoring data demonstrates that SFTI-LVAE achieves a 96.67% fault detection accuracy with zero false alarms, providing early warning 6.47 h before lubrication failure. Unlike traditional anomaly detection methods that only classify conditions as abnormal or normal, the proposed continuous health index reveals gradual tribological degradation processes, capturing subtle viscosity–temperature relationships and wear particle evolution indicating early lubrication regime transitions. The health index correlates strongly with tribological performance indicators, enabling a transition from reactive maintenance to predictive tribological management, providing an innovative solution for equipment health evaluation in the digital tribology era. Full article

Situated at the intersection of social history and psychology, this study examines how early Christian communities in Bithynia-Pontus navigated the persecution narrated in Pliny the Younger’s Epistle X 96. Through systematic textual analysis of Latin and Greek sources—triangulated with comparative evidence from Tacitus and corroborating archaeological data—and interpreted through Conservation-of-Resources and Social Identity theoretical frameworks, we reconstruct the repertoire of collective coping strategies mobilised under Roman repression. Our findings show that ritualised dawn assemblies, mutual economic assistance, and a theologically grounded expectation of post-mortem vindication converted external coercion into internal cohesion; these practices neutralised informer threat, sustained group morale, and ultimately expanded Christian networks across Asia Minor. Moreover, Pliny’s ad hoc judicial improvisations reveal the governor’s own bounded rationality, underscoring the reciprocal nature of stress between the persecutor and persecuted. By mapping the dynamic interaction between imperial policy and subaltern agency, the article clarifies why limited, locally triggered violence consolidated rather than extinguished the nascent movement. The analysis contributes a theoretically informed, evidence-based account of religious-minority resilience, enriching both early Christian historiography and broader debates on group survival under systemic duress. Full article

The terms fillenoert, villemort, feulje mort, and fillemot are obsolete historical color names derived from the French feuille morte (dead leaf), referred to a broad spectrum of brownish, yellowish, greenish, and reddish hues in early modern textile dyeing. This study investigates the visual identity and chromatic range of dead leaf by reconstructing dye recipes from seventeenth- and eighteenth-century European dyeing manuals. Using historically accurate materials and techniques, wool samples were dyed and analyzed through CIELAB color measurements to quantify their hue values. The results reveal that dead leaf does not correspond to a single, fixed color but represents a flexible and metaphorical category, reflecting both the natural variation in dead foliage and the diversity of historical dyeing practices. In early modern Europe, colors were often descriptive, frequently referencing the natural world or objects. These descriptors offered a nuanced vocabulary that extended far beyond today’s basic chromatic terms. Reworking these recipes reveals the complex interplay between chromatic language, material practices, and color perception. Historical color names served not merely as labels but encoded information about dye sources, cultural associations, and socio-economic contexts. Understanding and reviving this terminology deepens our appreciation of early dyeing traditions and bridges past and present conceptions of color. Full article

We describe the first use of phage therapy in Canada for the treatment of a life-threatening periprosthetic joint infection (PJI), with successful outcome. PJI is a devastating complication of joint replacement surgery, with high morbidity and mortality. Our patient presented with early sepsis from a chronic recalcitrant multidrug-resistant (MDR) Staphylococcus epidermidis hip PJI which had repeatedly failed standard therapy. She had previously undergone 10 operations of the right hip, and only three weeks after completing a prolonged course of daptomycin following her most recent hip revision, she developed a draining sinus tract. Given the high burden of disease, inability to achieve surgical source control, and lack of antibiotic treatment options for long-term suppressive therapy, bacteriophage (phage) therapy was pursued. The patient underwent irrigation and debridement with complex flap reconstruction: intraoperative tissue cultures again yielded MDR S. epidermidis. We developed a novel phage therapy protocol for this patient, with twice daily, intra-articular and intravenous (7 × 10⁹ PFU/dose) phage delivery over a planned 14-day course. Complete healing of the wound with cessation of drainage occurred within one month after treatment. A marked improvement in right hip pain and mobility occurred within three months after treatment. Twelve months following phage treatment, there is normalization of serum inflammatory markers with diminished pain, increased mobility, and no recurrent surgery. Our patient continues to improve and is currently living independently at home, with sustained clinical control of infection. Full article